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Some countries have experienced marked increases in pertussis incidence, morbidity and mortality, especially among young infants. To protect infants too young to be vaccinated, several countries recommend tetanus-diphtheria-acellular pertussis (Tdap) immunization during pregnancy, preferably during late second or third trimester. Protection is postulated to result from transplacental transfer of enhanced maternal levels of pertussis-specific antibodies. Maternal immunization with Tdap vaccine has been shown to be highly effective in preventing pertussis disease in young infants, but instances of vaccine failure have been reported. Maternally derived antibodies also have the potential to blunt infants’ immune responses to primary pertussis immunization, but the clinical relevance of this is unclear. Maternal titers of pertussis antibodies decline rapidly following parturition so re-immunization is likely needed in subsequent pregnancies. While scientific evidence supporting maternal immunization against pertussis is accumulating, there are still important knowledge gaps that should be addressed by future research.

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